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General NPI Number Information
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NPI Number | 1083766869
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Entity Type | Individual
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Provider Name | FRANK ELIZARDE BONGOLAN JR. DC
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 12/28/2011
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Provider Practice Location Address
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Address Line | 425 EL PINTADO RD STE. 180
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City | DANVILLE
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State | CA
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Zip | 94526-1848
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Country | US
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Telephone | 925-596-1100
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Fax | 925-328-1138
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Provider Business Mailing Address
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Address Line | PO BOX 596
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City | DANVILLE
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State | CA
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Zip | 94526-0596
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Country | US
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Telephone | 925-596-1100
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Fax | 925-362-1726
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | DC28772
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License Number State | CA
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